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Safety and Early Outcomes of Cochlear Implantation of Nucleus Devices in Infants: A Multi-Centre Study. 婴儿人工耳蜗植入 "核 "设备的安全性和早期疗效:多中心研究
IF 2.6 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241261480
Tal Honigman, Sharon L Cushing, Blake C Papsin, Susan Waltzman, Jennifer Woodard, Sara Neumann, Matthew B Fitzgerald, Karen A Gordon

This multi-center study examined the safety and effectiveness of cochlear implantation of children between 9 and 11 months of age. The intended impact was to support practice regarding candidacy assessment and prognostic counseling of pediatric cochlear implant candidates. Data in the clinical chart of children implanted at 9-11 months of age with Cochlear Ltd devices at five cochlear implant centers in the United States and Canada were included in analyses. The study included data from two cohorts implanted with one or two Nucleus devices during the periods of January 1, 2012-December 31, 2017 (Cohort 1, n = 83) or between January 1, 2018 and May 15, 2020 (Cohort 2, n = 50). Major adverse events (requiring another procedure/hospitalization) and minor adverse events (managed with medication alone or underwent an expected course of treatment that did not require surgery or hospitalization) out to 2 years post-implant were monitored and outcomes measured by audiometric thresholds and parent-reports on the IT-MAIS and LittlEARS questionnaires were collected. Results revealed 60 adverse events in 41 children and 227 ears implanted (26%) of which 14 major events occurred in 11 children; all were transitory and resolved. Improved hearing with cochlear implant use was shown in all outcome measures. Findings reveal that the procedure is safe for infants and that they show clear benefits of cochlear implantation including increased audibility and hearing development.

这项多中心研究考察了 9 到 11 个月大儿童人工耳蜗植入的安全性和有效性。研究的目的是为儿童人工耳蜗植入候选者的候选资格评估和预后咨询提供实践支持。美国和加拿大的五家人工耳蜗植入中心对 9-11 个月大时植入科利耳公司设备的儿童的临床病历数据进行了分析。研究纳入了在 2012 年 1 月 1 日至 2017 年 12 月 31 日期间(队列 1,n = 83)或 2018 年 1 月 1 日至 2020 年 5 月 15 日期间(队列 2,n = 50)植入一个或两个 Nucleus 设备的两个队列的数据。对植入后两年内的主要不良事件(需要再次手术/住院治疗)和轻微不良事件(仅通过药物治疗或接受预期疗程治疗,不需要手术或住院治疗)进行监测,并收集听阈测量结果以及家长对 IT-MAIS 和 LittlEARS 问卷的报告。结果显示,在 41 名儿童和 227 只植入耳朵(26%)中发生了 60 起不良事件,其中 11 名儿童发生了 14 起重大事件;所有事件都是暂时性的,并已得到解决。所有结果均显示,使用人工耳蜗可改善听力。研究结果表明,人工耳蜗植入术对婴儿是安全的,而且婴儿明显受益于人工耳蜗植入术,包括听力提高和听力发育。
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引用次数: 0
Spatial Release From Masking With Bilateral Bone Conduction Stimulation at Mastoid for Normal Hearing Subjects. 双侧乳突骨传导刺激正常听力受试者的掩蔽空间释放。
IF 2.7 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241234202

This study investigates the effect of spatial release from masking (SRM) in bilateral bone conduction (BC) stimulation at the mastoid. Nine adults with normal hearing were tested to determine SRM based on speech recognition thresholds (SRTs) in simulated spatial configurations ranging from 0 to 180 degrees. These configurations were based on nonindividualized head-related transfer functions. The participants were subjected to sound stimulation through either air conduction (AC) via headphones or BC. The results indicated that both the angular separation between the target and the masker, and the modality of sound stimulation, significantly influenced speech recognition performance. As the angular separation between the target and the masker increased up to 150°, both BC and AC SRTs decreased, indicating improved performance. However, performance slightly deteriorated when the angular separation exceeded 150°. For spatial separations less than 75°, BC stimulation provided greater spatial benefits than AC, although this difference was not statistically significant. For separations greater than 75°, AC stimulation offered significantly more spatial benefits than BC. When speech and noise originated from the same side of the head, the "better ear effect" did not significantly contribute to SRM. However, when speech and noise were located on opposite sides of the head, this effect became dominant in SRM.

本研究调查了在乳突处进行双侧骨传导(BC)刺激时,掩蔽的空间释放(SRM)效果。九名听力正常的成年人接受了测试,以确定在 0 到 180 度的模拟空间配置中基于语音识别阈值 (SRT) 的 SRM。这些配置基于非个性化的头部相关传递函数。参与者通过耳机或 BC 接受空气传导(AC)的声音刺激。结果表明,目标和掩蔽者之间的角度间隔以及声音刺激方式都会对语音识别成绩产生显著影响。当目标与掩蔽者之间的角度间隔增加到 150°时,BC 和 AC SRT 均下降,表明语音识别能力有所提高。但是,当角度间隔超过 150° 时,语音识别能力略有下降。当空间间隔小于 75°时,BC 刺激比 AC 刺激带来的空间益处更大,尽管这种差异在统计学上并不显著。当空间间隔大于 75°时,交流刺激的空间效益明显高于 BC。当语音和噪声来自头部的同一侧时,"顺耳效应 "对 SRM 的影响不大。然而,当语言和噪声位于头部的两侧时,这种效应在 SRM 中变得占主导地位。
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引用次数: 0
An Adaptive Leaky-Integrate and Firing Probability Model of an Electrically Stimulated Auditory Nerve Fiber. 电刺激听觉神经纤维的自适应漏电积分和点燃概率模型
IF 2.6 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241286742
Rebecca C Felsheim, Mathias Dietz

Most neural models produce a spiking output and often represent the stochastic nature of the spike generation process via a stochastic output. Nonspiking neural models, on the other hand, predict the probability of a spike occurring in response to a stimulus. We propose a nonspiking model for an electrically stimulated auditory nerve fiber, which not only predicts the total probability of a spike occurring in response to a biphasic pulse but also the distribution of the spike time. Our adaptive leaky-integrate and firing probability (aLIFP) model can account for refractoriness, facilitation, accommodation, and long-term adaptation. All model parameters have been fitted to single cell recordings from electrically stimulated cat auditory nerve fibers. Afterward, the model was validated on recordings from auditory nerve fibers from cats and guinea pigs. The nonspiking nature of the model makes it fast and deterministic while still accounting for the stochastic nature of the spike generation process. Therefore, the relationship between the input to the model or model parameters and the model's output can be observed more directly than with stochastically spiking models.

大多数神经模型都会产生尖峰输出,并通常通过随机输出来表示尖峰产生过程的随机性。而非尖峰神经模型则预测尖峰对刺激做出反应的概率。我们提出了一种电刺激听觉神经纤维的非尖峰模型,它不仅能预测尖峰对双相脉冲产生反应的总概率,还能预测尖峰时间的分布。我们的自适应漏积分和点燃概率(aLIFP)模型可以解释折射、促进、调适和长期适应。所有模型参数都与电刺激猫听觉神经纤维的单细胞记录相匹配。随后,该模型在猫和豚鼠的听觉神经纤维记录中得到了验证。该模型的非尖峰特性使其既快速又具有确定性,同时还考虑到了尖峰产生过程的随机性。因此,与随机尖峰模型相比,可以更直接地观察到模型输入或模型参数与模型输出之间的关系。
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引用次数: 0
Externalization of Speech When Listening With Hearing Aids. 使用助听器聆听时的言语外化
IF 2.7 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241229572

Subjective reports indicate that hearing aids can disrupt sound externalization and/or reduce the perceived distance of sounds. Here we conducted an experiment to explore this phenomenon and to quantify how frequently it occurs for different hearing-aid styles. Of particular interest were the effects of microphone position (behind the ear vs. in the ear) and dome type (closed vs. open). Participants were young adults with normal hearing or with bilateral hearing loss, who were fitted with hearing aids that allowed variations in the microphone position and the dome type. They were seated in a large sound-treated booth and presented with monosyllabic words from loudspeakers at a distance of 1.5 m. Their task was to rate the perceived externalization of each word using a rating scale that ranged from 10 (at the loudspeaker in front) to 0 (in the head) to -10 (behind the listener). On average, compared to unaided listening, hearing aids tended to reduce perceived distance and lead to more in-the-head responses. This was especially true for closed domes in combination with behind-the-ear microphones. The behavioral data along with acoustical recordings made in the ear canals of a manikin suggest that increased low-frequency ear-canal levels (with closed domes) and ambiguous spatial cues (with behind-the-ear microphones) may both contribute to breakdowns of externalization.

主观报告显示,助听器会破坏声音的外化和/或减少声音的感知距离。在此,我们进行了一项实验,以探索这种现象,并量化不同助听器款式出现这种现象的频率。我们尤其关注麦克风位置(耳后与耳内)和圆顶类型(封闭式与开放式)的影响。参与者均为听力正常或有双侧听力损失的年轻人,他们佩戴的助听器允许麦克风位置和圆顶类型发生变化。他们坐在一个经过声音处理的大房间里,在距离 1.5 米处用扬声器播放单音节词。他们的任务是使用评分量表对每个单词的感知外化程度进行评分,评分量表的范围从 10(在前面的扬声器处)到 0(在头部)再到-10(在听者身后)。平均而言,与无助听相比,助听器往往会减少感知距离,导致更多的头内反应。这一点在封闭式耳罩与耳后麦克风结合使用时尤为明显。行为数据以及在人体模型耳道中进行的声学记录表明,耳道低频水平的增加(使用封闭式耳罩)和模糊的空间线索(使用耳后麦克风)可能都会导致外化的中断。
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引用次数: 0
A Step Toward Precision Audiology: Individual Differences and Characteristic Profiles From Auditory Perceptual and Cognitive Abilities. 迈向精准听力学的一步:听觉感知和认知能力的个体差异和特征描述。
IF 2.6 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241263485
Dana Cherri, David A Eddins, Erol J Ozmeral

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals' auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH (n = 20) and OHL (n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing.

听力正常或患有老年性听力损失的老年人在嘈杂环境中聆听语音时面临着挑战。为了更好地为有交流障碍的人提供服务,除了纯音阈值外,还需要精确的诊断方法来描述个人的听觉感知和认知能力。在同一人群中,不同个体的这些能力可能存在差异。本研究的目的是考虑阈上变异性,并为听力正常(ONH)和听力损失(OHL)的老年人建立特征档案。使用便携式自动快速测试仪对听力正常(ONH)(n = 20)和听力损失(OHL)(n = 20)的听觉感知和认知能力进行了简短测试。通过聚类分析,发现每组有三个主要特征,尽管听阈相似,但听觉知觉和认知能力却存在差异。方差分析显示,听觉神经元在掩蔽的空间释放、"咿呀学语 "测试、认知、噪音中的音调和双耳时间处理能力方面存在差异。OHL在掩蔽的空间释放、辱骂测试、认知和对背景噪声的耐受性方面存在差异。相关分析表明,两组人的听觉能力和认知能力之间存在显著关系。这项研究表明,在听力正常的情况下,以及在听力损失程度相似的听者中,都可能存在不同程度的听觉感知和认知障碍。这项研究的结果说明,除了纯音阈值和言语测试之外,还需要考虑个体差异并制定有针对性的干预方案。
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引用次数: 0
Note on the Dual-Task Paradigm and its Use to Measure Listening Effort. 双任务范式及其用于测量听力努力程度的说明。
IF 2.6 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241292215
Stefanie E Kuchinsky, Frederick J Gallun, Adrian K C Lee

People regularly communicate in complex environments, requiring them to flexibly shift their attention across multiple sources of sensory information. Increasing recruitment of the executive functions that support successful speech comprehension in these multitasking settings is thought to contribute to the sense of effort that listeners often experience. One common research method employed to quantify listening effort is the dual-task paradigm in which individuals recognize speech and concurrently perform a secondary (often visual) task. Effort is operationalized as performance decrements on the secondary task as speech processing demands increase. However, recent reviews have noted critical inconsistencies in the results of dual-task experiments, likely in part due to how and when the two tasks place demands on a common set of mental resources and how flexibly individuals can allocate their attention to them. We propose that in order to move forward to address this gap, we need to first look backward: better integrating theoretical models of resource capacity and allocation as well as of task-switching that have been historically developed in domains outside of hearing research (viz., cognitive psychology and neuroscience). With this context in mind, we describe how dual-task experiments could be designed and interpreted such that they provide better and more robust insights into the mechanisms that contribute to effortful listening.

人们经常在复杂的环境中进行交流,这就要求他们在多种感官信息源之间灵活转换注意力。在这些多任务环境中,支持成功理解语音的执行功能被认为是造成听者经常感到费力的原因。量化听力努力程度的一种常用研究方法是双任务范式,即个人在识别语音的同时执行一项次要任务(通常是视觉任务)。随着语音处理需求的增加,听力强度会随着次要任务的完成而降低。然而,最近的评论指出,双任务实验的结果存在严重的不一致性,部分原因可能是这两项任务如何以及何时对一组共同的心理资源提出要求,以及个体如何灵活地将注意力分配给它们。我们建议,为了弥补这一差距,我们首先需要向后看:更好地整合资源能力和分配以及任务切换的理论模型,这些模型历来是在听力研究以外的领域(即认知心理学和神经科学)发展起来的。有鉴于此,我们将介绍如何设计和解释双任务实验,使其能更好、更有力地揭示有助于努力倾听的机制。
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引用次数: 0
Hearing Aid Amplification Improves Postural Control for Older Adults With Hearing Loss When Other Sensory Cues Are Impoverished. 当其他感官线索贫乏时,助听器放大可改善听力损失老年人的姿势控制。
IF 2.7 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241232219

Recent studies suggest that sound amplification via hearing aids can improve postural control in adults with hearing impairments. Unfortunately, only a few studies used well-defined posturography measures to assess balance in adults with hearing loss with and without their hearing aids. Of these, only two examined postural control specifically in the elderly with hearing loss. The present study examined the impact of hearing aid use on postural control during various sensory perturbations in older adults with age-related hearing loss. Thirty individuals with age-related hearing impairments and using hearing aids bilaterally were tested. Participants were asked to perform a modified clinical sensory integration in balance test on a force platform with and without hearing aids. The experiment was conducted in the presence of a broadband noise ranging from 0.1 to 4 kHz presented through a loudspeaker. As expected, hearing aid use had a beneficial impact on postural control, but only when visual and somatosensory inputs were both reduced. Data also suggest that hearing aid use decreases the dependence on somatosensory input for maintaining postural control. This finding can be of particular importance in older adults considering the reduction of tactile and proprioceptive sensitivity and acuity often associated with aging. These results provide an additional argument for encouraging early hearing aid fitting for people with hearing loss.

最近的研究表明,通过助听器放大声音可以改善听力受损成年人的姿势控制。遗憾的是,只有少数研究使用了定义明确的体位测量法来评估有听力损失的成年人在佩戴和未佩戴助听器时的平衡能力。在这些研究中,只有两项专门研究了听力损失老年人的体位控制。本研究考察了助听器的使用对患有老年性听力损失的老年人在各种感觉干扰时的姿势控制的影响。研究人员对 30 名患有老年性听力障碍并双侧使用助听器的人进行了测试。受试者被要求在有助听器和没有助听器的情况下,在力平台上进行改良的临床感觉统合平衡测试。实验是在通过扬声器播放 0.1 至 4 kHz 宽带噪音的情况下进行的。正如预期的那样,使用助听器对姿势控制有好处,但只有当视觉和体感输入都减少时才会产生这种效果。数据还表明,使用助听器可降低维持姿势控制对体感输入的依赖。考虑到触觉和本体感觉的敏感度和敏锐度通常会随着年龄的增长而降低,这一发现对老年人尤为重要。这些结果为鼓励听力损失患者尽早验配助听器提供了新的论据。
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引用次数: 0
Relationships Between Speech, Spatial and Qualities of Hearing Short Form SSQ12 Item Scores and their Use in Guiding Rehabilitation for Cochlear Implant Recipients. 言语、空间和听力质量短表 SSQ12 项目得分之间的关系及其在指导人工耳蜗植入者康复中的应用。
IF 2.7 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165231224643

Cochlear implantation successfully improves hearing in most adult recipients. However, in rare cases, post-implant rehabilitation is required to maximize benefit. The primary aim of this investigation was to test if self-reports by cochlear implant users indicate the need for post-implant rehabilitation. Listening performance was assessed with the Speech, Spatial and Qualities short-form SSQ12, which was self-administered via a web-based survey. Subjects included over 2000 adult bilateral or unilateral cochlear implant users with at least one year of experience. A novel application of regression tree analysis identified core SSQ12 items that serve as first steps in establishing a plan for further rehabilitation: items 1, 8, and 11 dealing with single-talker situations, loudness perception, and clarity, respectively. Further regression and classification tree analyses revealed that SSQ12 item scores were weakly related to age, degree of tinnitus, and use of bilateral versus unilateral implants. Conversely, SSQ12 scores were strongly associated with self-rated satisfaction and confidence in using their cochlear implant. The SSQ12 total scores did not vary significantly over 1-9 or more years' experience. These findings suggest that the SSQ12 may be a useful tool to guide rehabilitation at any time after cochlear implantation. Identification of poor performance may have implications for timely management to improve the outcomes, through various techniques such as device fitting adjustments, counseling, active sound exposure, and training spatial hearing.

人工耳蜗植入术能成功改善大多数成年受术者的听力。然而,在极少数情况下,需要进行植入后康复训练才能最大限度地获益。这项调查的主要目的是测试人工耳蜗用户的自我报告是否表明需要进行植入后康复。听力表现通过言语、空间和素质短式 SSQ12 进行评估,SSQ12 通过基于网络的调查进行自我管理。调查对象包括 2000 多名使用人工耳蜗至少一年的成年双侧或单侧用户。通过回归树分析的新颖应用,确定了 SSQ12 的核心项目,这些项目是制定进一步康复计划的第一步:项目 1、8 和 11 分别涉及单声道情况、响度感知和清晰度。进一步的回归和分类树分析表明,SSQ12 项目得分与年龄、耳鸣程度以及使用双侧与单侧植入体的关系不大。相反,SSQ12 分数与使用人工耳蜗的自评满意度和信心密切相关。SSQ12 总分在 1-9 年或更长时间内没有显著变化。这些研究结果表明,SSQ12 可能是指导人工耳蜗植入术后任何时间康复的有用工具。通过各种技术,如设备安装调整、咨询、主动声音暴露和空间听力训练等,识别不良表现可能对及时处理以改善结果有影响。
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引用次数: 0
Amplitude Compression for Preventing Rollover at Above-Conversational Speech Levels. 压缩振幅,防止在高于对话语音水平时出现翻转。
IF 2.7 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165231224597
Michal Fereczkowski, Raul H Sanchez-Lopez, Stine Christiansen, Tobias Neher

Hearing aids provide nonlinear amplification to improve speech audibility and loudness perception. While more audibility typically increases speech intelligibility at low levels, the same is not true for above-conversational levels, where decreases in intelligibility ("rollover") can occur. In a previous study, we found rollover in speech intelligibility measurements made in quiet for 35 out of 74 test ears with a hearing loss. Furthermore, we found rollover occurrence in quiet to be associated with poorer speech intelligibility in noise as measured with linear amplification. Here, we retested 16 participants with rollover with three amplitude-compression settings. Two were designed to prevent rollover by applying slow- or fast-acting compression with a 5:1 compression ratio around the "sweet spot," that is, the area in an individual performance-intensity function with high intelligibility and listening comfort. The third, reference setting used gains and compression ratios prescribed by the "National Acoustic Laboratories Non-Linear 1" rule. Speech intelligibility was assessed in quiet and in noise. Pairwise preference judgments were also collected. For speech levels of 70 dB SPL and above, slow-acting sweet-spot compression gave better intelligibility in quiet and noise than the reference setting. Additionally, the participants clearly preferred slow-acting sweet-spot compression over the other settings. At lower levels, the three settings gave comparable speech intelligibility, and the participants preferred the reference setting over both sweet-spot settings. Overall, these results suggest that, for listeners with rollover, slow-acting sweet-spot compression is beneficial at 70 dB SPL and above, while at lower levels clinically established gain targets are more suited.

助听器提供非线性放大,以改善语言可听性和响度感知。虽然更高的可听度通常会提高低声级的言语清晰度,但高于对话声级的言语清晰度却并非如此,此时会出现清晰度下降("翻转")的情况。在之前的一项研究中,我们发现在 74 只听力损失的测试耳中,有 35 只在安静环境下进行的语言清晰度测量中出现了滚转现象。此外,我们还发现,在安静环境下出现的翻转现象与线性放大测量的噪音环境下较低的言语清晰度有关。在这里,我们用三种振幅压缩设置重新测试了 16 名有翻转现象的参与者。其中两种设置的目的是通过在 "甜点 "周围以 5:1 的压缩比进行慢速或快速压缩来防止翻转,"甜点 "是指个人性能强度函数中具有高清晰度和听觉舒适度的区域。第三种参考设置使用 "国家声学实验室非线性 1 "规则规定的增益和压缩比。语音清晰度在安静和噪音环境下进行评估。同时还收集了两两之间的偏好判断。对于 70 dB SPL 及以上的语音水平,慢动作甜点压缩在安静和噪音环境下的清晰度均优于参考设置。此外,与其他设置相比,参与者明显更喜欢慢动作甜点压缩。在较低的音量下,三种设置的语音清晰度不相上下,与两种甜点设置相比,学员更喜欢参考设置。总之,这些结果表明,对于有滚动现象的听者来说,在 70 dB SPL 及以上时,慢动作甜点压缩是有益的,而在较低水平时,临床确定的增益目标更适合。
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引用次数: 0
Perceptual Consequences of Cochlear Deafferentation in Humans. 人类耳蜗失聪的感知后果
IF 2.7 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-01-01 DOI: 10.1177/23312165241239541

Cochlear synaptopathy, a form of cochlear deafferentation, has been demonstrated in a number of animal species, including non-human primates. Both age and noise exposure contribute to synaptopathy in animal models, indicating that it may be a common type of auditory dysfunction in humans. Temporal bone and auditory physiological data suggest that age and occupational/military noise exposure also lead to synaptopathy in humans. The predicted perceptual consequences of synaptopathy include tinnitus, hyperacusis, and difficulty with speech-in-noise perception. However, confirming the perceptual impacts of this form of cochlear deafferentation presents a particular challenge because synaptopathy can only be confirmed through post-mortem temporal bone analysis and auditory perception is difficult to evaluate in animals. Animal data suggest that deafferentation leads to increased central gain, signs of tinnitus and abnormal loudness perception, and deficits in temporal processing and signal-in-noise detection. If equivalent changes occur in humans following deafferentation, this would be expected to increase the likelihood of developing tinnitus, hyperacusis, and difficulty with speech-in-noise perception. Physiological data from humans is consistent with the hypothesis that deafferentation is associated with increased central gain and a greater likelihood of tinnitus perception, while human data on the relationship between deafferentation and hyperacusis is extremely limited. Many human studies have investigated the relationship between physiological correlates of deafferentation and difficulty with speech-in-noise perception, with mixed findings. A non-linear relationship between deafferentation and speech perception may have contributed to the mixed results. When differences in sample characteristics and study measurements are considered, the findings may be more consistent.

耳蜗突触病是耳蜗失聪的一种形式,已在包括非人灵长类动物在内的许多动物物种中得到证实。在动物模型中,年龄和噪音暴露都会导致突触病,这表明突触病可能是人类听觉功能障碍的一种常见类型。颞骨和听觉生理数据表明,年龄和职业/军事噪声暴露也会导致人类突触病。根据预测,突触病的感知后果包括耳鸣、听觉障碍和噪音中的语言感知困难。然而,确认这种形式的耳蜗失聪对知觉的影响是一项特殊的挑战,因为突触病只能通过尸检颞骨分析来确认,而听觉知觉很难在动物身上进行评估。动物数据表明,耳蜗失聪会导致中枢增益增加、耳鸣症状和响度感知异常,以及时间处理和噪声信号检测缺陷。如果人类在去发声后发生了同样的变化,预计会增加出现耳鸣、听觉障碍和噪声中语音感知困难的可能性。来自人类的生理学数据与下述假设相一致,即去发声与中枢增益增加和耳鸣感知可能性增大有关,而关于去发声与听觉亢进之间关系的人类数据则极为有限。许多人类研究调查了去感受化的生理相关性与噪声中言语感知困难之间的关系,结果不一。失音与言语感知之间的非线性关系可能是导致结果不一的原因之一。如果考虑到样本特征和研究测量的差异,研究结果可能会更加一致。
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引用次数: 0
期刊
Trends in Hearing
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